Synthesis of budesonide conjugates and their anti-inflammatory effects: a preliminary study

Direct cyclodextrin based powder extrusion 3D printing of budesonide loaded mini-tablets for the treatment of eosinophilic colitis in paediatric patients

The purpose of this study was to combine direct powder extrusion (DPE) 3D printing and fluid bed coating techniques to create a budesonide (BD) loaded solid oral formulations for the treatment of eosinophilic colitis (EC) in paediatric patients. The preferred medication for EC treatment is BD, which has drawbacks due to its poor water solubility and low absorption. Additionally, since commercially available medications for EC treatment are created and approved for adult patients, administering them to children sometimes requires an off-label use and an impromptu handling, which can result in therapeutic ineffectiveness. The DPE 3D approach was investigated to create Mini-Tablets (MTs) to suit the swallowing, palatability, and dose flexibility control requirements needed by paediatric patients. Additionally, DPE 3D and the inclusion of hydroxypropyl-β-cyclodextrin in the initial powder mixture allowed for an improvement in the solubility and rate of BD dissolution in aqueous medium. Then, to accomplish a site-specific drug release at the intestinal level, MTs were coated with a layer of Eudragit FS 30D, an enteric polymer responsive at pH > 7.0 values. In vitro release experiments showed that film-coated MTs were suitable in terms of size and dose, enabling potential therapeutic customization and targeted delivery of BD to the colon.

Identification and Quantification by NMR Spectroscopy of the 22R and 22S Epimers in Budesonide Pharmaceutical Forms

The authors developed four variants of the qNMR technique (¹H or ¹³C nucleus, DMSO-d6 or CDCl₃ solvent) for identification and quantification by NMR of 22R and 22S epimers in budesonide active pharmaceutical ingredient and budesonide drugs (sprays, capsules, tablets). The choice of the qNMR technique version depends on the drug excipients. The correlation of ¹H and ¹³C spectra signals to molecules of different budesonide epimers was carried out on the basis of a comprehensive analysis of experimental spectral NMR data (¹H-¹H gCOSY, ¹H-¹³C gHSQC, ¹H-¹³C gHMBC, ¹H-¹H ROESY). This technique makes it possible to identify budesonide epimers and determine their weight ratio directly, without constructing a calibration curve and using any standards. The results of measuring the 22S epimer content by qNMR are comparable with the results of measurements using the reference HPLC method.

Matrix tablets based on a novel poly (magnesium acrylate) hydrogel for the treatment of inflammatory bowel diseases

The objective of this work was to evaluate the potential use of a new polymer (PAMgA) in the development sustained release matrix tablets for the treatment of bowel inflammatory diseases. For this purpose, budesonide, a highly lipophilic compound, was used as model drug. Tablets with two reticulation grades of PAMgA (PAMgA 5 and 40) and with 9 mg of budesonide were developed and characterized. All the studies were carried out using biorelevant media (FaSSGF and FaSSIF). Swelling and erosion of PAMgA tablets was influenced by the reticulation grade of the polymer and the biorelevant media assayed, being water uptake higher for PAMgA 40 tablets in intestinal fluid, whereas PAMgA 5 showed more intense erosion in this biorelevant medium. Budesonide was released slowly from PAMgA tablets, both in gastric and intestinal environment, following Super case II transport kinetics (relaxation-controlled delivery), with a lag time of around 1-2 h. When the dissolution medium was changed sequentially throughout the trial, 75% of the budesonide dose was released in a sustained manner between 4 and 20 h of testing from PAMgA tablets, showing a more controlled budesonide release than Entocort® and Budenofalk® (commercially available sustained release formulations of budesonide). In conclusion, PAMgA polymer allows controlling the release of highly lipophilic drugs as budesonide, being an useful excipient for the development of sustained release matrix tablets.

The effect of montelukast sodium plus budesonide on the clinical efficacy, inflammation, and pulmonary function in children with cough variant asthma

OBJECTIVE

The aim of this study is to explore the clinical efficacy of montelukast sodium (MKST) combined with budesonide (BUD) on children with cough variant asthma (CVA) and its influence on inflammation and pulmonary function (PF).

METHODS

One hundred and sixty-six children with CVA treated in the Affiliated Nanhua Hospital, University of South China from May 2017 to August 2019 were randomized into a joint group (JG, n=92) for the combination therapy of MKST and BUD, and a control group (CG, n=74) for BUD monotherapy. Their clinical symptoms, total response rates (RR), PF, and inflammatory factor expressions were evaluated before and after treatment. The adverse reactions during the treatment were statistically compared between the two groups, and the factors influencing the curative effect were analyzed using logistic regression.

RESULTS

The JG presented markedly less cough resolution times, expectoration and wheezing, and a shorter body temperature recovery time than the CG after the treatment. The post-treatment forced expiratory volume in 1 second (FEV1), the forced vital capacity (FVC), the FEV1/FVC and the peak expiratory flow (PEF) levels as well as the Asthma Control Test (ACT) scores were statistically higher in the JG than in the CG. The JG had notably lower IgE, TNF-α, and IL-8 levels than the CG after the treatment. The total RR in the JG was observably higher than it was in the CG after the treatment, but the total adverse reaction rate identified no evident difference between the two series. Children with a family history of allergies, a family medical history, low ACT scores, high IgE expressions, high TNF-α expressions, and high IL-8 expressions, as well as BUD intervention are at increased risk of reduced efficacy.

CONCLUSIONS

The reduction of efficacy in children with CVA results from multiple risk factors. MKST combined with BUD can ameliorate the PF of children with CVA, reduce their inflammatory factors, and improve the curative effect and the prognosis.